TREATMENT IN CASES OF MILD DIABETES

There are instances of patients with diabetes who have lived for twenty years or more without any effort at treatment. This consoling thought must not make unwary the patient with a moderately severe or severe form of the disease. It is safer to overrate the seriousness of the condition than to commit an irreparable blunder and neglect the careful management of a serious condition. Children and young adults, for instance, may seem well during the first year after the appearance of sugar, but with few exceptions they develop the severest form of the disease later unless they are very carefully treated from the first.

A good many older persons may be treated satisfactorily with much less dietary restriction than is necessary in the severe cases. When this is possible, insulin is not needed and should not be used, or, in other words, if a condition is serious enough to require insulin, it is serious enough to require an accurately weighed diet. Occasionally patients have so little intelligence that it is hopeless to expect them to carry on the weighed diet in their homes. For such, and also for patients with very mild diabetes, the following general advice is usually beneficial:

  1. Avoid sugar and all foods made with sugar, such as candy, jelly, marmalade, syrup and molasses, pies, cakes, puddings and pastries. Saccharin may be used if desired: one-fourth grain saccharin will equal one teaspoonful of sugar in sweetening value.
  2. Avoid cereals (breakfast foods) and cereal products, such as mush, macaroni, spaghetti and noodles.
  3. Use bread only in very small amounts, not over one ounce at a meal. Whole wheat or white breads are preferable to any so-called diabetic breads. Gluten bread, brown bread and corn bread vary widely in compositions and it is safer to avoid them.
  4. Potatoes, bananas, apples, peas, dried beans, carrots, beets, turnips and onions should be used in small quantities, and not oftener than once a day.
  5. Dried fruits should be avoided. Use fresh fruits whenever possible. Fruits canned without sugar are permissible. They may be purchased on the market or prepared at home. Fruits may be taken every day as substitutes for other desserts.
  6. Vegetables that grow above the ground, except peas and dried beans, should be eaten in quantities sufficient to avoid hunger. Three ordinary servings of these vegetables may be included in each meal. Canned vegetables are palatable and wholesome. Fresh vegetables are, however, preferable.
  7. Meat and eggs should be eaten sparingly. As much harm may result from excessive protein as from excessive carbohydrate. The diet for the day should never contain more than 60 grams (2 ounces) of lean meat, weighed cooked, and three eggs. Thirty grams (1 ounce) of bacon, weighed cooked, may be included. Meat includes chicken, game, and fish.
  8. Fats, including butter or oleomargarine, nut butter, bacon fat, olive oil, Wesson oil, or other salad oil may be eaten freely.
  9. Cream is a very useful food for diabetic patients, and may be taken freely. Milk is relatively high in carbohydrate and less nutritious.
  10. The amount of fat, such as butter or cream, should be adjusted so as to provide adequate, but not excessive, nutrition. A rising body-weight calls for less food and, under such circumstances, the amount of fat should be reduced.
  11. Coffee and tea should be used sparingly, not in excess of one cupful of either at each meal.
  12. Condiments, such as salt, pepper and vinegar, may be used in reasonable amount.

If sugar appears in the urine, bread should be omitted. If it persists after thus reducing the carbohydrate intake, the condition of the patient is severe enough to warrant instituting the more accurate management discussed herein.